Postaxial hypoplasia of the lower extremity associated with congenital dislocation of the patella

Autor: Sergio Charles-Lozoya, MSc, Gibran Ruíz-Zenteno, BS, Héctor Cobos-Aguilar, PhD, María Lizcano-Martínez, BS, Edgar Manilla-Muñoz, PhD, Miguel Leonardo De La Parra-Márquez, MSc, Adrián García-Hernández, MD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Medicine, Vol 101, Iss 25, p e29283 (2022)
Druh dokumentu: article
ISSN: 0025-7974
1536-5964
00000000
DOI: 10.1097/MD.0000000000029283
Popis: Abstract. Rationale:. Evaluation of clinical and radiologic abnormalities in patients with postaxial hypoplasia of the lower extremity (PHLE) for treatment decisions represents a major challenge, which is more complicated when PHLE is associated with congenital dislocation of the patella. Patient concerns. : Herein, we present the case of an 8-year-old female patient with evident length inequality in her left lower extremity and inability to walk. Diagnoses:. Radiological evaluation revealed PHLE with fibular hemimelia, proximal femoral focal deficiency, tarsal coalition, and congenital patellar dislocation of the patella. The right lower extremity was also affected by fibular hemimelia. Interventions and outcomes:. Surgical management included the Roux-Goldthwait technique for patellofemoral joint realignment, a medial knee stapled with Blount technique, and femur enlargement using the Wagner technique. The results from surgical intervention included a left femoral elongation of 6.7 cm featuring callus with angulation, displacement, and a discrepancy of 5 cm between femurs with a flexor contraction in the knee of −15° and a centralized knee. Lesson:. PHLE accompanied by congenital dislocation of the patella has not been extensively described in the literature; therefore, there is no established management. Starting reconstruction at an early age, together with an adequate classification of the deformity, are essential factors when opting for limb reconstruction.
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